Organization Name: | VIVIEN B DEITZ LCSW PA |
NPI Number: | 1649292517 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VIVIEN B DEITZ (PRESIDENT) |
Mailing Address: | 10726 Brewer House Road North Bethesda |
State: | MD US |
Postal Code: | 208523420 |
Phone Number: | 3017701111 |
Fax Number: | 3017700260 |
NPI Enumeration Date: | 07/23/2006 |
NPI Last Update Date: | 05/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 5221 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |